Job Description

Full-Time

Monday - Friday

Accountable for conversion of diagnoses and treatment procedures into codes using an international classification of diseases. Requires skill in the sequencing of diagnoses/procedures to optimize reimbursement. Ensures that records are coded in an accurate and timely manner.

OF ESSENTIAL JOB FUNCTIONS

• Ensures that records are coded within 36 hours of discharge, excluding weekends and holidays.
• Reviews medical record thoroughly to ascertain all diagnoses/procedures.
• Queries healthcare providers in accordance to the department query policy.
• Refers medical record to director, If there is a question regarding the diagnoses/codes.
• Utilizes computerized coding/abstracting equipment.
• Codes all diagnoses/procedures in accordance to ICD coding principles and the Coding Manual.
• Reviews coding periodicals within seven (7) days of receipt.
• Ensures data quality and optimum reimbursement allowable under the federal and state payment systems.
• Acts as a resource person to hospital staff for coding and may provide education regarding coding changes/issues.
• Must be familiar with all medical record and coding requirements, including Inpatient and Outpatient, Along with the various insurance provider requirements, such as Medicare, Medicaid, and Blue Cross.
• Account for all records and notifies the director of any not received.
• Assembles medical records according to forms placement guidelines.
• Audits and analyzes medical records for completeness and accuracy.
• Enters deficiencies into computer, check records out, and forward to appropriate physician for completion.
• Follows the filing schedule.
• Performs other duties as assigned by the director.

BASIC SKILLS

• Basic computer skills

EDUCATION AND WORK EXPERIENCE REQUIRED

• AHIMA certification preferred. (RHIA, RHIT, CCS or CCA)
• 2 or more years of previous hospital experience as a Coder preferred
• Knowledge of diagnoses/procedures in accordance with ICD coding principles for both inpatient and outpatient.
• Knowledge of CIHQ standards and state regulations for acute care facilities.

LANGUAGE SKILLS

• Ability to read and communicate effectively in English.
• Additional language a plus

PHYSICAL REQUIREMENTS

• There can be prolong keyboarding, sitting and standing with this position. There is moderate kneeling, crouching, stooping, and crawling while retrieving and filing records. There is moderate reaching, pulling and pushing with arms and hand.
• Must be able to lift 50 pounds occasionally.